
<div class="title">
    <h2><?= lang ( 'checkout.payment.info' ) ?></h2>
</div>

<form action="<?= base_url ( 'excursions/checkout_customer' ) ?>" method="post" id="customer_form">

    <input type="hidden" value="<?= $booking_info->excid ?>" name="excid" />
    <input type="hidden" value="<?= $booking_info->noadult ?>" name="noadult" />
    <input type="hidden" value="<?= $booking_info->noch ?>" name="noch" />
    <input type="hidden" value="<?= $booking_info->persons ?>" name="persons" />
    <input type="hidden" value="<?= $booking_info->adultprice ?>" name="adultprice" />
    <input type="hidden" value="<?= $booking_info->chprice ?>" name="chprice" />
    <input type="hidden" value="<?= $booking_info->totalprice ?>" name="totalprice" />
    <input type="hidden" value="<?= $booking_info->date ?>" name="date" />
    <input type="hidden" value="Localhost" name="s_b_i" />
    <input type="hidden" value="<?= $booking_info->pickup_location ?>" name="pickup_location" />

    <div class="inner-form">

        <fieldset>
            <h3><span><?= lang ( 'checkout.personal.information' ) ?></span></h3>
            <ul>
                <li>
                    <label><?= lang ( 'checkout.name.surname' ) ?><small>*</small>:</label>
                    <input type="text" value="" name="name" id="name">
                </li>
                <li>
                    <label><?= lang ( 'checkout.telephone' ) ?><small>*</small>:</label>
                    <input type="text" value="" name="phone" id="phone">
                </li>
                <li>
                    <label><?= lang ( 'checkout.email' ) ?><small>*</small>:</label>
                    <input type="text" value="" name="email" id="email">
                </li>
                <li>
                    <label><?= lang ( 'checkout.note' ) ?>:</label>
                    <textarea name="note" id="note"></textarea>
                </li>
            </ul>
        </fieldset>

        <fieldset>
            <h3><span><?= lang ( 'checkout.your.address' ) ?></span></h3>
            <ul>
                <li>
                    <label><?= lang ( 'checkout.address' ) ?><small>*</small>:</label>
                    <input type="text" value="" name="address" id="address">
                </li>
                <li>
                    <label><?= lang ( 'checkout.city' ) ?><small>*</small>:</label>
                    <input type="text" value="" name="city" id="city">
                </li>
                <li>
                    <label><?= lang ( 'checkout.zip' ) ?><small>*</small>:</label>
                    <input type="text" value="" name="zip" id="zip">
                </li>
                <li>
                    <label><?= lang ( 'checkout.country' ) ?>:</label>

                    <select name="country" id="country">
                        <option value='0'><?= lang ( 'please_select' ) ?></option>
                        <?
                            foreach ( config_item ( 'country_list' ) as $key => $country )
                                echo "<option value='{$country}'>{$country}</option>";
                        ?>
                    </select>

                </li>
            </ul>
        </fieldset>

        <fieldset class="clearfix fieldset-bottom">
            <h3><span><?= lang ( 'menu.terms.conditions' ) ?></span></h3>
        </fieldset>
        <p><input type="checkbox" name="terms" id="terms" /> <span><?= lang ( 'checkout.agree.terms.conditions' ) ?> <a href="#" id="terms_buttom"><?= lang ( 'checkout.agree.terms' ) ?></a></span></p>

    </div>

    <div class="buttons-cart">
        <a href="#" class="checkout_2_back">« <?= lang ( 'checkout.back' ) ?></a>
        <input type="submit" value="<?= lang ( 'checkout.next' ) ?> »" id="customer_submit_button" disabled="disabled">
    </div>

</form>